In 1348 a terrible plague, the “Black Death,” ravaged Europe. Scientists now believe it was the bubonic plague, carried from Asia to Europe by infected rats. But at the time, people had not the slightest understanding of what had befallen them. In their terror, they turned against the “politically correct” villain of the day—Europe’s Jews—whom they accused of poisoning the wells in order to destroy Christendom. Massive pogroms took place all across Europe. Needless to say, this early attempt to root out disease only added to the overall horror.
Over subsequent centuries, societies gradually evolved better approaches to public health issues. Improved sanitation in nineteenth-century America curtailed typhoid, tuberculosis, and yellow fever, and twentieth—century antibiotics and vaccines virtually eliminated polio and smallpox. Central to these and other medical breakthroughs is a scientific habit of mind that rejects fuzzy social theorizing, and subjects all explanations of disease to rigorous and demanding standards of proof.
But the monster of political correctness, according to Dr. Sally Satel (a practicing psychoanalyst and a lecturer at Yale’s School of Medicine), is not so easily vanquished. Disenchanted with rigorous scientific standards and hard-headed analysis, a growing number of medical professionals have turned to a new academic fad: social productionism. The basic idea behind “social productionism” is that society—through its racist, sexist, and “classist” institutions—is the real source of most of the diseases that afflict us. Fighting disease thus requires medical professionals to set aside traditional health concerns and join the struggle for social justice.
How widespread is this new worldview? According to Satel, social-productionists “now sit at the helm of professional associations and hold impressive posts in schools of public health.” They are highly active in legislative and political debates, have changed admissions criteria for medical school, and “have infiltrated respected academic journals.” Though “practitioners of PC medicine” are not yet the “majority in the health professions,” membership and influence are increasing. “Most disturbing,” writes Satel, “their stubborn reluctance to acknowledge each person’s responsibility in preserving his own health threatens to reverse many of the gains made by public health movements in the past century.”
In PC, M.D., Dr. Satel has accumulated a vast body of evidence in support of this thesis. Consider, for example, recent grants awarded by the prestigious National Institutes of Health. Researchers are now getting paid to examine the relationship between health and “powerlessness,” health and “discrimination,” health and “racism,” and even health and “classism.” Or consider this recent excerpt from the Annals of Epidemiology, written by a researcher at the Centers for Disease Control: “We the scientific community are no different from the public or the media: We bring everything we have been taught by our culture—our xenophobia, our racism, our sexism, our ‘classism,’ our tendency to ‘otherize.'” Finally, consider how Dr. Harvey V. Fineberg, former dean of the Harvard School of Public Health, describes his institution: “A school of public health is like a school of justice.”
But how can the pursuit of justice help us deal with such dread diseases as AIDS? Well, as Sally Zierler of Brown University’s Department of Public Health has explained, AIDS is “a biological expression of social inequality.” Her five recommendations for curbing the AIDS epidemic, delivered during a lecture to the annual meeting of the American Public Health Association in 1998, were: Limit the power of corporations, cap salaries of CEOs, eliminate corporate subsidies, prohibit corporate contributions to politicians, and strengthen labor unions.
Fifty years ago, this sort of analysis would have been dismissed as “vulgar Marxism.” But the people Satel is describing have advanced far beyond traditional Marxist categories of analysis. Here, for example, is an excerpt from a session between a politically enlightened therapist and her patient:
Ruth: I know it sounds silly, but I just feel fat, old and ugly these days.
Therapist: But that’s the way we are trained to think. And if a woman looks like hell, she feels like hell because she is devalued in our society…. Our bodies are the single most powerful asset we have in our society. You might try thinking about your weight by discovering ways in which being fat affords you power in your relationships and begin to love yourself just the way you are.
Ruth: That won’t be easy.
Therapist: I know. It wasn’t easy for me either …. I forced myself to look at my body and learn to love it.
How comforting to know that, when overweight Ruth drops dead of a heart attack, at least she will not have succumbed to the sexist notion of feminine pulchritude.
Dr. Satel’s important book contains, many more examples of this kind of breathtaking intellectual perversity—each more outrageous than its predecessor. It also demonstrates how these new ideas are changing the way medicine is being practiced—through an abomination called “multicultural counseling,” for example, whereby patients are segregated for treatment along racial lines. But what is most disturbing about PC, M.D. is the sense one gets that, although many of her colleagues recognize social-productionists as dangerous ideologues intent on dragging public health back to the Middle Ages, Dr. Satel is one of the few mavericks courageous enough to take them on. Evidently, what Yeats said at the start of the twentieth century—”The best lack all conviction, while the worst are full of passionate intensity”—applies no less to the twenty first.